For all but the simplest injuries, the doctor may recommend that the injury
be treated by an orthopaedic surgeon (a doctor who specializes in bone and joint
problems in children and adults). Some problems may require the services of a
pediatric orthopaedic surgeon, who specializes in injuries and musculoskeletal
disorders in children.
How Are Growth Plate Injuries Treated?
As indicated in the previous section, treatment depends on the type of
fracture. Treatment, which should be started as soon as possible after injury,
generally involves a mix of the following:
Immobilization
The affected limb is often put in a cast or splint, and the child is told to
limit any activity that puts pressure on the injured area.
Manipulation or Surgery
If the fracture is displaced, the doctor will have to put the bones or joints
back in their correct positions, either by using his or her hands (called
manipulation) or by performing surgery (open reduction and internal fixation).
After the procedure, the bone will be set in place so it can heal without
moving. This is usually done with a cast that encloses the injured growth plate
and the joints on both sides of it. The cast is left in place until the injury
heals, which can take anywhere from a few weeks to two or more months for
serious injuries. The need for manipulation or surgery depends on the location
and extent of the injury, its effect on nearby nerves and blood vessels, and the
child's age.
Strengthening and Range-of-Motion Exercises
These treatments may also be recommended after the fracture is healed.
Long-Term Followup
Long-term followup is usually necessary to monitor the child's recuperation
and growth. Evaluation includes x rays of matching limbs at 3- to 6-month
intervals for at least 2 years. Some fractures require periodic evaluations
until the child's bones have finished growing. Sometimes a growth arrest line
may appear as a marker of the injury. Continued bone growth away from that line
may mean that there will not be a long-term problem, and the doctor may decide
to stop following the patient.
Fractures occur when bone cannot withstand the outside forces applied to the bone. Fractures can be open or closed. Types of fractures include: greenstick, spiral, comminuted, transverse, compound, or vertebral compression. Common fractures include: stress fracture, compression fracture, rib fracture, and skull fracture. Treatment depends upon the type of fracture.
Osteomyelitis is an infection of the bone. Potential causes include injections around the bone, fractures that puncture the skin, recent surgeries, and bacterial infections that travel from other areas of the body, spreading through the blood to the bone. Symptoms include pain, fever, chills, stiffness, and nausea. Treatment involves antibiotics and pain medications. Surgery is sometimes necessary.
An injury to a ligament is called a sprain, and an injury to muscle or tendon is called a strain. Sprains and strains may be caused by repetitive movements or a single stressful incident. Symptoms include pain and swelling. Though treatment depends upon the extent and location of the injury, rest, ice, compression, and elevation are key elements of treatment.
Child abuse falls into four categories: neglect, physical abuse, sexual abuse, and emotional abuse. There are certain risk factors that predispose a child to being abused and an adult to abusing a child. Risk factors for children are age, children with learning disabilities, adopted and foster children, children with congenital abnormalities, and a past history of abuse. Parental risk factors include young or single parents, those who suffered abuse themselves, adults with substance-abuse problems or psychiatric disease, and those who didn't graduate from high school.
Juvenile arthritis (juvenile rheumatoid arthritis or JRA) annually affects one child in every thousand. There are three types of JRA: pauciarticular (less than four joints affected), polyarticular (more than four joints affected), and systemic-onset (inflamed joints with high fevers and rash). Treatment of juvenile arthritis depends upon the type the child has and should focus on treating the symptoms that manifest.
There are two categories to cold weather-related injuries. 1) no freezing of body tissue (trench foot and chilblains), and 2) freezing of body tissues (frostbite). Chilblains in general, will not need medical attention (unless there is infection). Trench foot and frostbite, however, require medical attention. Symptoms of frostbite include pain, burning, numbness, and eventually a complete loss of sensation in the affected body part. The young, elderly, and patients with certain medical conditions (diabetes, hypothyroidism, circulatory problems, and psychiatric illnesses), are more susceptible to cold weather-related injuries. People who abuse alcohol and illicit drug user are also at risk for cold weather-related injuries.
Children's health is focused on the well-being of children from conception through adolescence. There are many aspects of children's health, including growth and development, illnesses, injuries, behavior, mental illness, family health and community health.
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